Although tacitly marketed by the tobacco industry as a safe substitute for cigarettes, smokeless tobacco is no such thing. Smokeless tobaccos cause a myriad of health problems – many of them potentially deadly – and individuals who use these products should make every effort to quit.
Unfortunately, in spite of new laws restricting tobacco advertising, young people appear to be particularly susceptible to claims that smokeless tobacco is less lethal than cigarettes. According to a 2007 CDC survey, more than 13% of male high school students and more than 2% of female high school students were using smokeless tobacco; this compares to a usage rate of 3% in adults over the age of 26 years. (1)
What Are the Health Risks of Smokeless Tobacco?
Though smokeless tobacco confers its own array of health problems, many of its deleterious health effects mirror those of cigarettes:
- stained teeth
- bad breath
- receding gums (shrinkage of gums from around the teeth)
- bone loss at the bases of the teeth
- wearing down of teeth
- tooth loss
- nicotine addiction (a “dipper” using two cans weekly gets as much nicotine as a 1 ½ pack-per-day smoker)
- leukoplakia (white areas in the mouth that progress to cancer)
- mouth and throat cancer
- esophageal cancer
- stomach cancer
- pancreatic cancer
- lung cancer (carcinogens in smokeless tobacco may cause lung cancer without being inhaled)
- heightened risk for heart attacks and stroke
Aside from the health risks, using smokeless tobacco can present a financial burden, especially for young people whose discretionary funds are often limited. A two-can-per-week habit can cost up to $80 monthly, depending on one’s state of residence.
Tips for Stopping the Smokeless Tobacco Habit
Nicotine, a substance that is naturally found in tobacco, is as addictive as heroin or cocaine. When nicotine is absorbed through the mucous membranes of the mouth (or nose, in the case of “snuffers”) it travels throughout the body and affects many organs and tissues; during pregnancy, nicotine freely crosses the placenta to affect the fetus.
Individuals who want to stop using smokeless tobacco – much like people who wish to stop smoking – must overcome both the physiologic and psychological aspects of nicotine addiction. However, the dose of nicotine that is delivered to the body from snuff or chewing tobacco is four to five times higher than that found in one cigarette, so stopping smokeless tobacco is more difficult for some people than giving up cigarettes.
Physiologic withdrawal from nicotine causes symptoms (anxiety, irritability, insomnia, headaches, etc.) that peak within two to three days after the last dip or chew. Such unpleasant symptoms then subside each day thereafter, but they can persist for several weeks.
Psychological withdrawal from nicotine involves the elimination of a habit or pattern that is often ingrained in the tobacco user’s daily routine and social structure; this aspect of withdrawal can be every bit as troubling as physical nicotine addiction.
Four key factors in tobacco cessation include:
- deciding to quit
- setting a quit date and developing a plan
- dealing with withdrawal
- avoiding relapse
In making the decision to quit, it often helps to write down the reasons for doing so. These can include worries about tobacco-related diseases, wanting to set an example for one's children, saving money, and so on.
Once a decision to quit has been made, a critical component of any tobacco cessation plan is a “stop date.” This date should not be too far in the future (to avoid the opportunity to change one's mind); it could be an important date (birthday, anniversary, etc.), or it could be during a vacation – changes in one’s routine may present good opportunities to avoid old patterns, but withdrawal can interfere with enjoyment of the vacation. The chosen stop date should be circled on a calendar and shared with family members and friends.
Plans for stopping tobacco and dealing with withdrawal should be realistic and tailored to the user: Support groups, tobacco tapering, nicotine replacement (e.g., nicotine gum or patches), prescription medications (Zyban or Chantix), tobacco substitutes (sunflower seeds, herbal snuffs, etc.), hypnosis, acupuncture, and other methods offer varying degrees of success; any or all should be considered by anyone who is serious about giving up tobacco.
Once abstinence has been established, it is frequently difficult to maintain one’s resolve to remain tobacco-free. It is helpful to permanently alter habits that were previously associated with tobacco use. Whenever temptation arises, it is critical to review one’s reasons for quitting…and the unpleasant experience of withdrawal that would have to be repeated in the event of relapse.
The American Cancer Society is a valuable source of information and advice for tobacco users who want to discard this dangerous and expensive habit.
Source:
1. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance, United States, 2007. Morbidity and Mortality Weekly Report 2007;57(SS-4):1–136
Stephen Allen Christensen - Dr. Steve Christensen's writing has appeared in magazines, professional journals, poetry anthologies, and children's books since 1976.
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